Animal Assisted Therapy Program

You and your best friend can bring a smile to patients during their stay at Elmhurst Memorial Hospital. We welcome your application for participation in our Animal Assisted Therapy Program if you are at least 18 years of age, and if your dog meets the following criteria:

  • Your dog sits and lays down with only one command
  • Your dog stays until you call him or her with only one command
  • He or she walks loosely on a leash and doesn't pull, even when excited
  • Your dog is friendly with other dogs
  • Your dog will perform commands without treats as a reward

We have other requirements, too, that will help you, your pet and our patients enjoy the Animal Assisted Therapy experience.

Your dog should:

  • Enjoy people
  • Not bark or whine too much
  • Be at least a year old
  • Be up-to-date on all vaccinations, including rabies
  • Not have any skin problems

We also ask that you do not use prong collars, gentle leaders or retractable leashes, and that you and your dog have completed a group obedience training class within the past six months.

Interested in donating to our Animal Assisted Therapy Program? Click here. Be sure to note in the comment field that your donation is for the Animal Assisted Therapy Program.

Volunteer Application

General Information
Name *
Address *
Suite, Apt, etc.
City *
State *
ZIP *
Home or Mobile Phone * ( ) -
Work ( ) -
E-mail *
Occupation *
Employer *
Referred By
Have you ever done dog therapy work? (With your current dog) * Yes
No
If Yes, Where?
Are you currently Dog/Therapy Certified: * Yes
No
If yes, by whom?
Date of Certification:
Dog Information
Dog Breed *
Age *
Dog Birth Date *
Name *
Gender * Male
Female
Spayed/Neutered * Yes
No
Weight *
Has your dog attended any obedience classes? * Yes
No
If yes, where and what level was completed?
Is your dog currently on year around Flea Protection? * Yes
No
What brand:
Heartguard Brand
Veterinarian *
Phone * ( ) -
Does your dog live with you? * Yes
No
How long?
Please include a written paragraph on why you are interested in participating in this type of program. *
VOLUNTEER SHIFTS
All volunteers will be required to work minimally once every other week. *
We currently have the following shifts (Check all the apply):









How much would you like to volunteer?
Number of days/week *
Number of days/month *
Are you a year around resident at the address listed above? * Yes
No
If you have additional questions or need a referral to a good obedience trainer to brush up on skills, please call (331) 221-0196.
Elmhurst Memorial Healthcare Network

This site is part of the Elmhurst Memorial Healthcare network of Web sites, which covers a variety of topics using the same philosophy: When it comes to medical care, we know that you have a lot of options. And we want you to know that you're more than a patient to us. You're an individual. We would appreciate the opportunity to provide you with state-of-the-art medical care and down-to-earth, personalized attention.

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